Skull Vibration Induced Nystagmus Test: Correlations with Semicircular Canal and Otolith Asymmetries.

Christol Fabre,Haoyue Tan,Sébastien Schmerber,Philippe Perrin,Ludovic Giraud,Georges Dumas

doi:10.3390/audiolres11040056

Abstract

Background: To establish in patients with peripheral vestibular disorders relations between skull vibration-induced nystagmus (SVIN) different components (horizontal, vertical, torsional) and the results of different structurally related vestibular tests. Methods: SVIN test, canal vestibular test (CVT: caloric test + video head impulse test: VHIT), otolithic vestibular test (OVT: ocular vestibular evoked myogenic potential oVEMP + cervical vestibular evoked myogenic potential cVEMP) performed on the same day in 52 patients with peripheral vestibular diseases (age < 65 years), and 11 control patients were analyzed. Mixed effects logistic regression analysis was performed to assert whether the presence of nystagmus in SVIN (3D analysis) have an association with the presence of peripheral vestibular dysfunction measured by vestibular explorations (CVT or OVT). Results: We obtained different groups: Group-Co (control group), Group-VNT (dizzy patients with no vestibular tests alterations), Group-O (OVT alterations only), Group-C (CVT alterations only), Group-M (mixed alterations). SVIN-SPV horizontal component was significantly higher in Group-M than in the other groups (p = 0.005) and correlated with alterations of lateral-VHIT (p < 0.001), caloric test (p = 0.002) and oVEMP (p = 0.006). SVIN-SPV vertical component was correlated with the anterior-VHIT and oVEMP alterations (p = 0.007; p = 0.017, respectively). SVIN-SPV torsional component was correlated with the anterior-VHIT positivity (p = 0.017). SVIN was the only positive test for 10% of patients (83% of Group-VNT). Conclusion: SVIN-SPV analysis in dizzy patients shows significant correlation to both CVT and OVT. SVIN horizontal component is mainly relevant to both vestibular tests exploring lateral canal and utricle responses. SVIN-SPV is significantly higher in patients with combined canal and otolith lesions. In some patients with dizziness, SVIN may be the only positive test.

Highlights

Vestibular disorders performant analysis is currently based on multifrequency and topographic tests which selectively explore all the different vestibular structures (Figure 1).Skull vibration induced nystagmus test (SVINT) is a non-invasive, well tolerated test which complements other vestibular tests in the vestibule multifrequency analysis [1]
The population was divided into five groups: Group-control group (Co), Group-VNT, Group-O, Group-C, and Group-M
This study aimed to assess whether the different components of skull vibration-induced nystagmus (SVIN) at 100 Hz can be correlated with canal vestibular tests (CVT) and/or otolith vestibular tests (OVT) and their corresponding vestibular structures to orientate toward a probable origin of SVIN and its application in clinical routine

Summary

Introduction

Vestibular disorders performant analysis is currently based on multifrequency and topographic tests which selectively explore all the different vestibular structures (Figure 1).Skull vibration induced nystagmus test (SVINT) is a non-invasive, well tolerated test which complements other vestibular tests in the vestibule multifrequency analysis [1]. SVIN is essentially produced by the response on the healthy side and acts as a vestibular Weber test, the induced nystagmus shows quick phases beating usually toward the side opposite to the lesion in unilateral vestibular-loss [5,6]. This test allows a simple access to Audiol. To establish in patients with peripheral vestibular disorders relations between skull vibration-induced nystagmus (SVIN) different components (horizontal, vertical, torsional) and the results of different structurally related vestibular tests. In some patients with dizziness, SVIN may be the only positive test

Objectives

Methods

Results

Discussion

Conclusion